Endoscopic fibrin glue injection for closure of pancreatocutaneous fistula following transgastric endoscopic necrosectomy.
Transgastric endoscopic necrosectomy has been recently introduced as the effective and alternative management of infected pancreatic necrosis and pancreatic abscess. However, up to 40% of patients who undergo endoscopic necrosectomy may need an additional percutaneous approach for subsequent peripancreatic fluid collection or non-resolution of pancreatic necrosis. This percutaneous approach may lead to persistent pancreatocutaneous fistula, which remains a serious problem and usually requires prolonged hospitalization, or even open-abdominal surgery. We describe the first case of pancreatocutaneous fistula and concomitant abdominal wall defect following transgastric endoscopic necrosectomy and percutaneous drainage, which were endoscopically closed with fibrin glue injection via the necrotic cavity.
Jang
Ji-Woong
JW
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Songpagu, Seoul 138-736, South Korea.
Park
Do-Hyun
DH
Moon
Sung-Hoon
SH
Lee
Sang-Soo
SS
Seo
Dong-Wan
DW
Lee
Sung-Koo
SK
Kim
Myung-Hwan
MH
D000269:Adhesives / Q000008:administration & dosage*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005337:Fibrin / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D009336:Necrosis; D010179:Pancreas / Q000473:pathology* / Q000601:surgery*; D010185:Pancreatic Fistula / Q000601:surgery*
D000269:Adhesives; D005337:Fibrin